Acute Lithiasis Cholecystitis; Particularities of Diagnosis and Treatment in the Elderly

Objectives. The incidence of acute cholecystitis increases with age, when patients usually associate additional comorbidities. Such comorbidities and the late presentation to the doctor make the treatment more complex, associating higher rates of complications. The present study aims to evaluate the methods of diagnosis and treatment applied to a group of older patients with acute cholecystitis. Materials and Methods. 585 patients were enrolled in the study between 2019-2023. The inclusion criteria in the study were represented by the diagnosis of acute cholecystitis in patients over 65 years old, while patients who refused to participate and those who presented complex locoregional pathologies (trauma, cancer, etc.) were excluded. Results. Acute cholecystitis was in about 90% of cases caused by gallstones. 61.36% of cases benefited from laparoscopic cholecystectomy, the rest of the patients requiring additional procedures or open surgery. Morbidity and mortality were not significantly influenced, but some of the patients required complex interventions and longer hospital stay. Conclusions. The clinical manifestations of acute cholecystitis can be diminished in some of the elderly patients (neurological disorders, diabetes, immunosenescence, etc.), being initially appreciated as mild forms. Later it is found (imaging, intraoperative) that these are much more severe forms, which often require a customized therapeutic approach.